The knowing-doing gap in acute stroke-Does stroke knowledge translate into action?

Analysis of the Factors Intervening in the Prehospital Time in a Stroke Code

INTRODUCTION

Strokes continue to be considered public health problems due to the great social and health impact they entail. They are the second cause of death in the world, with a high incidence and prevalence. They are time-dependent diseases, and more than 80% of cases could be avoidable with greater management of risk factors.

OBJECTIVE

to analyze the factors that influence prehospital time in a stroke code. Assess the population's knowledge of stroke symptoms and teach them how to act when a case is suspected. Document the continued training of health professionals for the early identification of patients with a suspected stroke. Demonstrate the importance of calling EMS as the first contact to reduce delays in prehospital time in a stroke.

METHODOLOGY

A bibliographic review was carried out focusing on articles published between December 2014 and August 2023. The following databases were consulted: Pubmed (Medline), Dialnet, Google Scholar, Web of Science (WOS), Scielo, Scopus, and ScienceDirect.

RESULTS

After applying the article selection criteria and evaluating the quality of the methodology, a total of 18 articles were obtained. The results affirm that the importance of achieving a reduction in prehospital time is based mainly on knowledge of the symptoms and the use of new technologies.

CONCLUSIONS

The evidence supports that the prehospital time of action in the stroke code is affected by numerous factors. These factors are determining factors in the time of action to achieve good effectiveness in the treatment of the pathology.

Exploring the self-efficacy and self-care-based stroke care model for risk factor modification in mild-to-moderate stroke patients

Context

The worldwide burden of stroke is projected to grow unless proper stroke education is implemented. Information alone cannot promote patient self-efficacy and self-care and reduce risk factors.

Aim

This trial aimed to test self-efficacy and self-care-based stroke education (SSE) on changes in self-efficacy, self-care, and risk factor modification.

Design setting and participants

This study is a single-center, double-blinded, interventional, two-arm randomized controlled trial with a 1- and 3-month follow-up in Indonesia. Between January 2022 and October 2022, 120 patients were prospectively enrolled from Cipto Mangunkusumo National Hospital, Indonesia. Participants were assigned using a computer-generated random number list.

Intervention

SSE was given before discharge from the hospital.

Primary outcome measure

Self-care, self-efficacy, and stroke risk score was measured 1 month and 3 months after discharge.

Secondary outcome measure

Modified Rankin Scale, Barthel Index, and blood viscosity was measured at 1 month and 3 months after discharge.

Results

A total of 120 patients (intervention n = 60; standard care n = 60) were randomized. In the 1st month, the intervention group showed a more significant change in self-care (4.56 [95% CI: 0.57, 8.56]), self-efficacy (4.95 [95% CI: 0.84, 9.06]), and stroke risk (-2.33 [95% CI:-3.19, -1.47]) compared to the controlled group. In the 3rd month, the intervention group also showed a more significant change in self-care (19.28 [95% CI: 16.01, 22.56]), self-efficacy (19.95 [95% CI: 16.61, 23.28]), and stroke risk (-3.83 [95% CI: -4.65, -3.01]) compared to the controlled group.

Conclusion

SSE may boost self-care and self-efficacy, adjust risk factors, enhance functional outcomes, and decrease blood viscosity.

Clinical trial registration

ISRCTN11495822.

The knowing-doing gap in acute stroke-Does stroke knowledge translate into action?

In this study, we suggest that there is a substantial knowing-doing gap in acute stroke, as increased stroke knowledge was not associated with earlier hospital admission.